The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

qc6Dqvbz6Bey3raXPfiKchQxNfADRIFhkWw6hvLVWIUVLLgQz8oFQHdYSiehaMN5JYdqVbiNtRw6kzRCyhaRMbEZKxhJjhsZ4Rg7nSXVXn2GLwFnSwvUJ5VB9dpS2M

Huntsman Cancer Institute EDI Feedback Form

The HCI Office of Equity, Diversity, & Inclusion (EDI) acts as a resource for our community to support in resolving immediate issues and implement long-term solutions that will foster greater belonging in our institution. This feedback form can be used to report anonymous concerns, request meetings, or to submit general EDI-related requests and suggestions.

The HCI Office of EDI Feedback Form includes the following:

Anonymous Reporting Form: Use this confidential form to report concerns or incidents anonymously, ensuring a safe space for sharing sensitive information.

In-Person Meeting Request Form: Our team is here to provide support and guidance on matters that foster a harmonious work atmosphere.

Department Training Request Form: Request EDI related trainings for your department. Our engaging sessions aim to foster understanding and inclusivity, empowering your team to contribute to a welcoming workplace.

General Feedback Form: We value your thoughts! Whether you have comments, suggestions, or requests, use this form to share your feedback. Your input helps us create a better experience for everyone.

A member of the EDI Leadership Team will review all forms and follows up with next steps as needed.

If you have additional questions, please contact our team directly at EDI@hci.utah.edu.

Please select from the dropdown

Please note, the HCI Office of EDI is not an investigative body. Any information provided in this form, or to a member of the EDI staff, will be used only for the purpose of identifying trends around HCI to better know where to implement solutions such as training.

Reports meeting the standard of the OEO Mandatory Reporting Policy will be submitted to the OEO Office for full investigation.

If you wish to make a completely anonymous report, please do not include your name.

Have you reported this issue before?

Yes

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Who did you report to?

This event occurred BY a:

Trainee or Student

Staff Member

Faculty Member

Patient or Caregiver

Community Member

Other

Please describe

TO a:

Trainee or Student

Staff Member

Faculty Member

Patient or Caregiver

Community Member

Other

Please describe

Please describe the event(s) you are reporting.

If you are reporting multiple isolated events, please separate them with line breaks.

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If you are comfortable, please describe the reason(s) for the consultation request.

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The HCI Office of EDI provides trainings and workshops for trainees, faculty and staff. Use the form to request a interactive training for your group (in-person or virtual).

Please note: submitting a workshop request is not a confirmation that the workshop will be scheduled.

Who is this training for? (department, team, committee, etc.)

Number of expected participants

Will this training be in-person or virtual?

Please describe the type of training you want for your group.

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Please add any additional details to help with context.

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Whether you have comments, suggestions, or requests, use this form to share your feedback.

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Your Name

Phone

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.